Physician Compare National (NPI:1003229352)

HEALTHCARE PROVIDER: TERRY CHEN D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003229352
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628340569
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170828001013
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHEN
	Individual professional last name
Provider First Name	TERRY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PACIFIC CENTRAL COAST HEALTH CENTERS
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9739091364
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	157
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2 JAMES WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 207
	Group Practice or individual's line 2 address
City	PISMO BEACH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	934494976
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8054345530
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MARIAN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050232
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FRENCH HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y